Provider Demographics
NPI:1093991184
Name:ROY HYMAN
Entity Type:Organization
Organization Name:ROY HYMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:HYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-966-2148
Mailing Address - Street 1:5202 PRESTON HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-2722
Mailing Address - Country:US
Mailing Address - Phone:502-966-2148
Mailing Address - Fax:502-964-7500
Practice Address - Street 1:5202 PRESTON HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-2722
Practice Address - Country:US
Practice Address - Phone:502-966-2148
Practice Address - Fax:502-964-7500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY758DT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0539180001Medicare NSC